Risk Factors for Cardiovascular Diseases and Prevention Strategies

To identify and treat risk factors for cardiovascular diseases, it is crucial to raise awareness from childhood and maintain it throughout life.

Importance of Preventing Cardiovascular Diseases

Atherosclerotic heart and vascular diseases are the leading cause of premature death worldwide.

In Europe, 42% of female deaths and 38% of male deaths before age 75 are due to cardiovascular diseases.

Atherosclerosis typically develops due to multiple risk factors. To prevent cardiovascular disease, a person’s total risk must be assessed, and higher-risk individuals require closer monitoring and treatment.

Impact of Reducing Cardiovascular Risk

• Reducing cardiovascular risk by just 1% prevents 25,000 cases of disease.

• In a European country, this can save 40 million euros annually.

Major Cardiovascular Risk Factors

Systematic risk assessment is essential for individuals with:

• Family history of early coronary artery disease,

• Hypertension,

• Diabetes mellitus,

• Smoking,

• High cholesterol.

Early coronary artery disease in the family refers to a first-degree male relative dying before age 55 or a first-degree female relative dying before age 65 from cardiovascular disease.

Physical Activity and Cardiovascular Health

Regular exercise is key to preventing cardiovascular disease, reducing both heart-related and overall mortality rates.

Recommendations for healthy individuals:

• At least 150 minutes of moderate-intensity aerobic activity per week, or

• 75 minutes of vigorous aerobic activity per week.

Examples of moderate-intensity exercise:

• Brisk walking,

• Light jogging,

• Dancing,

• Skipping rope,

• Swimming,

• Table tennis,

• Slow cycling.

Examples of vigorous-intensity exercise (where breathing is difficult, and talking is limited to a few words):

• Running,

• Basketball,

• Volleyball,

• Tennis,

• Step aerobics.

Individuals at risk should undergo exercise stress testing before engaging in intense activity.

Smoking Cessation: The Most Cost-Effective Prevention Method

Quitting smoking is the most cost-effective way to prevent cardiovascular disease.

Key recommendations:

• Protect non-smokers from secondhand smoke,

• Utilize smoking cessation centers and medications,

• Apply marketing restrictions to electronic cigarettes, similar to traditional cigarettes.

Impact of Weight on Cardiovascular Disease

Both being overweight and obesity increase the risk of cardiovascular diseases and mortality.

Maintaining a healthy weight positively affects:

• Blood pressure,

• Blood sugar levels,

• Cholesterol,

• Overall disease risk.

A healthy weight is defined as a Body Mass Index (BMI) between 20 and 25 kg/m².

Role of LDL Cholesterol in Atherosclerosis

It is scientifically proven that high LDL cholesterol levels contribute to atherosclerosis.

Primary goal: Reduce LDL cholesterol levels. Alternative marker: Non-HDL cholesterol can also be used as a target.

Medication is prescribed based on other risk factors:

• A heart attack patient requires LDL-lowering drugs even if LDL is 100 mg/dL.

• A person with no risk factors might not need medication even if LDL is 190 mg/dL.

Hypertension and Cardiovascular Risk

Hypertension is the most serious risk factor for heart and brain diseases.

Treatment success is determined by lowering blood pressure, not by the type of medication used.

Treatment goals:

• Below 140/90 mmHg for individuals under 60 years old.

• Slightly higher systolic values may be acceptable for individuals over 60.

Monitoring recommendations:

• A single measurement is not enough.

• 24-hour blood pressure monitoring may be needed.

Diabetes and Cardiovascular Risk

Diabetes prevalence has risen significantly in recent years.

As diabetes affects multiple organs, a multidisciplinary approach is essential for preventing complications.

Potential complications include:

• Damage to small and large blood vessels,

• Kidney failure,

• Stroke,

• Severe heart disease.

Recommendations:

• HbA1C should be below 7 to prevent cardiovascular complications.

• Insulin should not be avoided if necessary.

• LDL and blood pressure targets are lower for diabetic patients.

Role of Physicians in Cardiovascular Disease Prevention

Primary care physicians and cardiologists play a critical role in reducing cardiovascular mortality.

The decline in cardiovascular deaths over the last 30 years is due to:

• Reduced smoking rates,

• Lower cholesterol and blood pressure levels,

• Advancements in cardiology.

If obesity and diabetes are better controlled, this decline will continue further.